新型冠状病毒感染流行期间妇幼儿童医院的防控应对措施

<正>新型冠状病毒肺炎的暴发和流行引起了各极政府的高度重视。国家卫健委要求各级妇幼保健机构要按照当地卫生健康行政部门的统一部署开展疫情防控工作,严格值班值守,规范分诊救治,落实报告制度,强化院感防控。控制医院感染成为目前预防传染病暴发流行的关键环节之一~([1])。随着疫情的暴发,我院迅速做出反应,具体防控应对措施总结如下。1新型冠状病毒感染在妇幼儿童的表现儿童和孕产妇是新型冠状病毒感染的肺炎的易感人群,儿童感染后有低中度发热、干咳、乏力、恶心呕吐、腹部不适或腹泻等症状,但有明确接触史(武汉旅行及家族聚集感     

新型冠状病毒肺炎疫情对不同人群心理的影响及心理干预的建议

新型冠状病毒肺炎疫情在全国迅速蔓延,给人们的生产、生活甚至生命造成了极大的影响和危害。新型冠状病毒肺炎发生突然,传播快速,除了躯体上的传播之外,疫情对不同人群的心理均可能造成不同程度的影响。无论是新型冠状病毒肺炎确诊患者、疫情防控一线医护人员、疾控人员和管理人员以及参加疫情应对的后方救援者,如现场指挥、组织管理人员、志愿者等,还是居家隔离的轻症患者(密切接触者、疑似患者)以及受疫情防控措施影响的疫区相关人群、易感人群、普通公众都可能出现心理健康问题。2020年1月27日,国家卫生健康委员会发布《新型冠状病毒感染的肺炎疫情紧急心理危机干预指导原则》[1],对防疫期间可能存在的心理问题提出了干预指导原则。因此,本文旨在探讨新型冠状病毒肺炎疫情对不同人群的心理影响以及提出相关心理干预的建议,以期减轻疫情所致的心理伤害。     

浅谈儿童新型冠状病毒感染的核酸检测

2019年12月首发于湖北省武汉市的新型冠状病毒肺炎(corona virus disease 2019,COVID-19)疫情火速蔓延,并迅速扩散,2020年2月11日国际病毒学分类委员会正式将新型冠状病毒命名为严重急性呼吸综合征冠状病毒2型(severe acute respiratory syndrome coronavirus 2,SARS-CoV-2)[1]。2020年2月2日,国家卫生健康委员会发布的《关于做好儿童和孕产妇新型冠状病毒感染的肺炎疫情防控工作的通知》中明确指出,儿童和孕产妇是COVID-19的易感人群。为了更好地指导和规范全国COVID-19的诊治工作,国家卫生健康委员会发布的《新型冠状病毒肺炎诊疗方案(试行第六版)》将核酸检测和基因测序作为COVID-19的确诊依据。     

儿童严重急性呼吸综合征冠状病毒2 型感染药物治疗的快速循证评价

目的:采用循证评价和文献综述的方法,总结和分析目前已发表的儿童严重急性呼吸综合征冠状病毒2型(SARS-CoV-2)感染病例、临床实践指南或专家共识以及儿童严重急性呼吸综合征(SARS)/中东呼吸综合征(MERS)感染药物治疗经验,以期为儿童SARS-CoV-2感染药物治疗方案的制定提供循证依据。方法:系统检索PubMed、EMBase、the Cochrane Library、CNKI(含新型冠状病毒肺炎专题知识库)、WanFang Data、SinoMed和中华医学会杂志社(新型冠状病毒防控和诊治专栏)等数据库,根据文献研究特点和需要,设置快速检索策略和时限,对符合纳入标准研究中的药物治疗部分进行总结和描述性分析。结果:最终纳入11篇报告儿童病例的研究或综述(共196例患儿)和8篇指南,对儿童SARS/MERS感染的药物治疗经验进行综述。截至目前,已报道儿童感染病例的药物治疗方案基本依从儿童SARS-CoV-2感染指南推荐,且与既往发表的儿童SARS/MERS的药物治疗经验基本一致。α-干扰素为最常应用和最多推荐的抗病毒药物,其他抗病毒药物的应用多参考成人用法,有效性和安全性需要临床研究进一步予以证实;糖皮质激素和人免疫球蛋白在重症患儿中的应用尚存在争议,需权衡利弊谨慎使用;抗菌药物治疗需严格把握用药指征;其他治疗(如中医药)同样需要更多数据予以支持。结论:目前对于儿童SARS-CoV-2感染,尚无确证有效的药物治疗方案,这与儿童SARS/MERS的药物治疗经验基本一致,药物治疗方案的制定仍需进一步临床试验证据和用药经验总结的支持。     

从1例儿童新型冠状病毒普通型肺炎浅析抗病毒药物临床应用

摘要：儿童是呼吸道病毒的易感人群,儿童新型冠状病毒肺炎（COVID-19）会存在新型冠状病毒（SARS-CoV-2）与其他常见呼吸道病毒混合感染的复杂情况。目前尚无确认有效的抗SARS-CoV-2药物,因此国家诊疗方案中推荐的药物用于儿童仍需谨慎。为提高抗病毒药物在COVID-19儿童患者中应用的安全性,本文结合1例儿童COVID-19普通型病例的诊治过程,剖析该病例的抗病毒药物治疗方案,建议抗病毒药物在非重型儿童COVID-19病例的应用中需要特别关注用法用量、给药途径、疗程,以及药品不良反应的密切监测和及时处理,供儿科临床参考。     

疫情期间，新生儿如何做好防护

正新型冠状病毒疫情爆发后,多地报告婴幼儿确诊病例。新生儿由于免疫系统发育不成熟,且存在特殊感染途径——母婴垂直传播的可能,是新型冠状病毒的易感人群之一。据此,华中科技大学附属同济医院儿科(湖北省儿童医学中心)联合产科共同撰写了《新型冠状病毒感染的肺炎流行期间新生儿管理指导意见(第一版)》,提醒各位家长在护理新生儿时需要知道的几个防护要点。     

中药护您度过疫情观察期

对于新型冠状病毒感染疾病的防治,专家建议加强中西医结合的作用,中医从一开始就要介入。各地因此纷纷发布中医药治疗方案。今日,我就以最近的《新型冠状病毒感染的肺炎诊疗方案(试行第五版)》中提到的医学观察期可用的几个中药方案做一个介绍。     

严重急性呼吸综合征冠状病毒2疫情期间儿童肾脏病房感染防控思维导图

严重急性呼吸综合征冠状病毒2(SARS-CoV-2)感染的疫情已经持续了近2个月,现处于疫情胶着的状态。因儿童SARSCoV-2感染症状不典型,慢性肾脏疾病(CKD)患儿是高危感染人群,儿童肾脏专科病房的管理在复工、返校压力下,面临疫情防控的新挑战,国家临床研究中心肾脏病房、重庆市医学会儿科专委会肾脏学组,为进一步做好肾脏专科病房的疫情防控工作,结合目前疫情和相关防控建议,推荐SARS-CoV-2疫情期间儿童肾脏病房感染防控思维导图,以供儿童肾脏专科病房参考。     

定点收治期间武汉泰康同济医院药事管理与药学服务实践

2019 年 12 月,新型冠状病毒肺炎(Corona Virus Disease-2019 ,COVID-19)首先在武汉暴发,该疾病随后被纳入乙类传染病,具有传染性强、传播速度快、易感人群广等特征[1 ].党中央、国务院高度重视,为集中收治大量被感染的患者,经中央军委批准,部队医务人员于2020-02-13 -20...     

《新型冠状病毒感染诊疗方案(试行第十版)》解读

随着对新型冠状病毒(SARS-CoV-2)认识的深入，为做好后续诊疗工作，SARS-CoV-2感染诊疗方案不断更新。该文对《新型冠状病毒感染诊疗方案(试行第十版)》进行解读，并与《新型冠状病毒肺炎诊疗方案》(试行第九版)比较，重点介绍新版诊疗方案的更新要点，以便更好地应用于临床实践。     

Degraded and undegraded carrageenans and experimental gastric and duodenal ulceration

The prevention of histamine-induced gastric and duodenal ulceration in the guinea-pig has been examined using a series of undegraded and degraded carrageenans. Undegraded carrageenans were active at lower doses than degraded carrageenans. The high viscosity of the undegraded carrageenans in solution prevented their use in larger doses. Degradation of carrageenan without serious loss of sulphate, gives a product which allows the dose to be increased to an extent that its effect more than offsets the slight loss in activity caused by the degradation. No single feature of carrageenan structure can be related to anti-ulcer activity although degradation, and hence reduction of molecular size, generally reduces activity. Sulphate contents over 30% have little apparent effect on activity; κ-carrageenans were not consistently different in anti-ulcer activity from Λ-carrageenans. This contrasts with the antipeptic activity of carrageenans where κ-carrageenans are less active than their Λ-counter-parts. As with antipeptic activity, the degree of anti-ulcer activity is probably determined by a combination of structural features which includes molecular size and polyanionic properties.     

Affective and Anxiety Disorders and Alcohol and Drug Dependence:

Depression and anxiety frequently coexist in patients with substance use disorders. This clinically-oriented article examiens the relationship between these conditions and emphasizes data showing that substances of abuse can cause signs and symptoms of both depression and anxiety. These substance-related syndromes appear to have a different course and prognosis than uncomplicated, independent anxiety and major depressive disorders, and clinicians should consider the role of alcohol and other drugs in all patients presenting with these complaints. The authors will also outline an approach for diagnosing and managing patients with the combination of a substance use and depressive or anxiety disorder.     

Alcohol and Substance Use and Abuse in Women and Children

No abstract available for this article.     

Excretion and biotransformation of alfentanil and sufentanil in rats and dogs

The excretion and biotransformation of alfentanil (ALF) and sufentanil (SUF), two recent analogues of the synthetic opioid fentanyl, were studied after single iv administration of the tritium-labeled drugs in male rats and dogs. The drugs were almost completely metabolized in the two species, which resulted in a large number of metabolites. The excretion of the metabolites was rapid and exceeded 95% within 4 days, except for that of ALF metabolites in dogs (about 85%). For ALF, excretion of the radioactivity with the urine (73% in rats, about 76% in dogs) exceeded that with the feces. For SUF, excretion of the radioactivity with the urine amounted to 38 and 60% and that with the feces to 62 and 40%, in rats and dogs, respectively. Bile-cannulated rats excreted 68% with the bile within 24 hr after SUF dosing, and about 22% of this biliary radioactivity was subjected to enterohepatic circulation. After an ALF dose, the biliary excretion amounted to 24%, and the enterohepatic circulation was minimal. The main metabolic pathways of the two drugs were the oxidative N-dealkylation at the piperidine nitrogen and at the amide nitrogen, oxidative O-demethylation, aromatic hydroxylation, and the formation of ether glucuronides. N-[4-(Hydroxymethyl)-4-piperidinyl]-N-phenylpropanamide (M6) was the main metabolite of both ALF and SUF in rats. In dogs, the glucuronide of N-(4-hydroxyphenyl)propanamide (M5) was the main metabolite of ALF. After SUF dosing in dogs, N-[4-(methoxymethyl)-4-piperidinyl]-N-phenylpropanamide was more abundant than M5.